Private hospitals to stop CGHS cashless scheme from March 7

In a blow to government employees, including those who have retired, the Central Government Health Service has announced withdrawal of cashless medical service in private hospitals empanelled with the CGHS scheme from March 7. Patients will henceforth have to cough up hospital charges and later claim the amount from the government, according to the new rule.

The move will affect 50 lakh serving employees and over 30 lakh pensioners, as well as their family members. At a conservative estimate, the total number of persons affected could well be over two crore.

The move was necessary, said the Association of Healthcare Providers India (or AHPI, the nodal body of private empanelled hospitals) for a number of reasons, the main ones being CGHS owes these hospitals around Rs 200 crore in unpaid services as well as “unreasonably low” CGHS tariffs that haven’t been revised for the last four years. A doctor’s consultation fee, for example, remains Rs 58.

Also, AHPI says CGHS makes “illegal” deductions of 10% on all payments leading to losses for member hospitals. AHPI claims the amount runs up to Rs 180 crore.

In Karnataka, 20 hospitals, all in Bangalore, are empanelled with AHPI. HCG, Apollo hospitals, MS Ramaiah Memorial Hospital and Bangalore Baptist Hospital, among others, will not provide the cashless health scheme from March 7.

“When we were empanelled with the government, it was agreed upon that we will get 10% rebate on treatment charges if the government pays within seven days. But now, this deduction has been made applicable even when the amount is unpaid for years. That’s illegal. This has led to huge losses for member hospitals amounting to over Rs 180 crore over the past three years,” says Dr Alexander Thomas, CEO, Bangalore Baptist hospital, who represents AHPI in Bangalore.

Some hospitals have put up a public notice to this effect, reading, “CGHS tariffs are unreasonably low and not been revised for the last four years, threatening the very existence of the medical service providers.”

Dr Naresh Shetty of AHPI said, “The empanelled hospitals have been providing services under most difficult circumstances. They had to deal with steep hikes in electricity and water tariff, consumables, wages, taxes. We’ve been requesting a revision since June 2013 but there’s been no response.”

Official speak

The dues are just one issue. The bigger issue is that a doctor’s consultation charge of Rs 58 is appalling. The fees for several procedures are abysmally low. We don’t want to let down our beneficiaries but we have no choice. We ask the CGHS to consider the rates of the National Accreditation Board for Hospitals & Healthcare Providers. We’ve suggested that if at all CGHS were to take tender route, let CGHS decide the rates based on lowest bid received from NABH – accredited hospitals. Adopting rates like this would be logical and rational. Treating a patient can’t be made similar to selling onions and potatoes.

Source:http://timesofindia.indiatimes.com/india/Private-hospitals-to-stop-CGHS-cashless-scheme-from-March-7/articleshow/31438842.cms

Procedure for payment and reimbursement of medical expenses under ECHS

No.22A(10)/2010/US(WE)/D(Res)Nol-VIII

Government of India
Ministry of Defence
(Department of Ex-Servicemen Welfare)

New Delhi, the 14th February 2014

To
Managing Director
Central Organisation,
ECHS New Delhi-10

Subject: Procedure for payment and reimbursement of medial expenses under ECHS: Processing of bills by Bill Processing Agency (BPA)

Sir,
1. Further to Gol letter No. 24(8)/03/US(WE)/D(Res) dated 19 Dec
2003 and 22A(10)/10/US(WE)/D(Res) dated 23 Feb 2012 and 05 Nov 2012.

2. I am directed to convey the sanction of the Government to extend the On-Line bill processing by the Bill Processing Agency (BPA) to under mentioned Regional Centres w.e.f. 1st April 2014.

(a) Bangalore.
(b) Chennai.
(c) Coimbatore.
(d) Dehradun.
(e) Jabalpur.
(f) Jammu.
(g) Mumbai.
(h) Nagpur.
(i) Patna.
(j) Allahabad.
(k) Ahmedabad.
(I) Ambala.
(m)Bareilly.
(n) Delhi(II).
(o) Guwahati.
(p) Hisar.
(q) Ranchi.
(r) Visakhapatanam.

3. One dedicated broadband Internet circuit {2Mbps(1:1)} and one standard 2Mbps broadband connection for each of the Regional Centres processing bills on line is sanctioned.

4. Procedure for Bill payment as authorised vide Govt letter 22A(10)110/US(WE)/D(Res) dated 23 Feb 2012 and 05 Nov 2012 will be followed by all Regional Centres and Polyclinic. All other contents of Govt letter mentioned in this para remain unchanged.

5. This issues with the concurrence of Ministry of Defence (Finance) vide their U.O. No.33(07)/2011-FP dated 02-12-2013.

Yours faithfully,

Sd/-
(H.K. Mallick )
Under Secretary to the Govt of India

Source:http://www.desw.gov.in/sites/upload_files/desw/files/pdf/US-WE-14-Feb-2014.pdf

REFUND OF CONTRIBUTION MADE BY PRE 1996 RETIREES


REFUND OF CONTRIBUTION MADE BY PRE 1996 RETIREES
Appx A
(Ref to Para 3(a) of C&L Sec SN No
13/49717-C/AG/ECHS dt 21 Feb 14)

REFUND OF CONTRIBUTION MADE BY PRE 1996 RETIREES

1. Though pre 1996 retirees were exempted from making contribution for becoming members of ECHS vide Hon’ble Supreme Court Order on Writ Petition (Civil) No 210 of 1999 dt 22 Aug 2006, however there are no instrs from the Govt regarding refund of ECHS contribution in r/o pre Jan 1996 retirees who had already made the contribution prior to the Judgment of the Hon’ble Supreme Court. Contempt petition in this regards filed by Reid Defence Officers Association vide (C) No 16 of 2007 in WP (C) No 210/1999 was dismissed by the Hon’ble Supreme Court on 03 Nov 2008.

2. However, the case for refund of ECHS contribution for pre 1996 retirees who became ECHS member by paying ECHS contribution has been taken up with MoD since 20 May 2010 by Central Org ECHS. MoD had intimated that it has been decided to examine the case after Cabinet decision on the recovery of excess amount of NPA granted to retired Armed Forces doctors is available. Since the NPA issue has now been settled, Do ESW has again been requested for issuing favourable instructions.

Source:http://echs.gov.in/images/pdf/ops/ops100.pdf